When the shrapnel struck Army Lt. Col. Arturo Lincón, it shattered against his body like glass.

One piece embedded in the left side of his jawline, while another ripped through a salivary gland, bounced off the jawbone, and pierced the back of his neck, severing an artery before lodging into a vertebra.

Lincón was among dozens of U.S. service members wounded during an Iranian drone strike on March 1.

The attack at Port Shuaiba in Kuwait, occurring on the second day of the U.S. war with Iran, claimed the lives of six troops involved in providing logistical support for critical supplies.

In the aftermath, intense debate has arisen over whether military leadership was adequately prepared to treat the wounded.

Affected service members and their families told The Associated Press about unrecognized injuries, poorly planned evacuations to medical centers, and administrative hurdles that disrupted follow-up care.

The Pentagon maintained that the medical response was appropriate.

In a rare step for active-duty troops, nine injured service members spoke on the record to the AP, describing a military medical apparatus that frequently left them fighting to secure treatment on their own.

The medical shortcomings were part of a broader sequence of failures stemming from the Port Shuaiba strike detailed by soldiers.

Both the Army and the Pentagon declined to comment, with the Army stating it had not yet briefed the families of the fallen regarding its internal inquiry into the incident.

This criticism comes against a backdrop of years of disinvestment and troop drawdowns across the Middle East under successive administrations seeking to end American involvement in the region.

Those choices left the region without any major military medical installations run by the U.S.

Among Lincón’s injuries was damage to his left vertebral artery, which supplies blood to the brain, placing him at risk of a stroke.

Despite a nurse expressing shock that he was still alive, the Army deemed his condition insufficiently severe to justify admission to Landstuhl Regional Medical Center, a key U.S. military facility in Germany.

Instead, he was dispatched to nearby barracks and instructed to book outpatient appointments on his own.

“I was just kind of on my own, at least it felt like that,” said Lincón, a veteran who served in both Iraq and Afghanistan.

His experience was far from unique.

Maj. Stephen Ramsbottom, who required surgery to remove shrapnel from his head, reported waiting more than four months just to receive the results of his MRI scan.

“I’ve had to build my own case for everything,” Ramsbottom told the AP. “It’s very frustrating.”

Immediately following the deadly strike, soldiers equipped with tourniquets and basic first-aid training treated one another before using Google to navigate to the nearest hospital in Kuwait City, approximately 20 minutes away.

Medevac flights transported the most critically injured out of Kuwait within two days.

Lincón, who was positioned roughly 7 feet (2.1 meters) from the explosion, spent a week hospitalized in Kuwait to undergo jaw surgery.

Medical personnel informed him that the blast’s force had ruptured his eardrum, temporarily blinded him, and caused a traumatic brain injury.

Meanwhile, Chief Warrant Officer 4 Rodney Bearman, who suffered shrapnel wounds from his face down to his legs, was sent alongside other troops to private homes of U.S. government employees.

The threat of ongoing missile and drone attacks from Iran rendered evacuation flights too hazardous.

Around ten days after the strike, the wounded soldiers were loaded onto a cargo aircraft. Strapped to the floor, troops including Bearman, who could barely lie down or eat, endured the flight.

Upon landing in Germany, Bearman said they discovered they had not been documented as combat casualties, preventing their admission to Landstuhl.

Due to what Bearman described as a coding error, they were directed to barracks for outpatient care, much like Lincón.

“Never did I think that if I was wounded that these things would happen,” said Bearman, a veteran with over 30 years of service, including time in Afghanistan.

“Some sacred trust that I thought would never be broken was broken.”

Lincón spent days without access to pain medication.

He carried a CD containing his medical records from Kuwait to show an emergency room doctor at Landstuhl, who expressed concern that a trauma team had not yet evaluated him.

The Pentagon noted that soldiers might not always be aware of initial evaluations, such as field concussion checks designed to identify symptoms like double vision or repeated vomiting.

In past conflicts in Iraq and Afghanistan, troops with mild TBIs and shrapnel wounds often returned to duty quickly. Many soldiers who spoke with the AP were unaware of the true severity of their brain injuries.

A Pentagon official explained to the AP that Landstuhl’s primary mission during combat situations is to stabilize patients for transport to specialized military facilities in the U.S., rather than admitting them.

At the same time, major medical centers closer to Kuwait have been shuttered over the years. Notably, the Air Force Theater Hospital at Joint Base Balad in Iraq was handed over to Iraqi authorities in 2011 as part of military withdrawal efforts.

In a statement, the Pentagon said that all wounded service members arriving at its facilities are evaluated and may be admitted based on injury severity in accordance with “healthcare-industry practices.”

After roughly a week in Germany, many injured troops were moved to Fort Hood in Texas to undergo the standard demobilization process for returning deployed forces.

Medical documentation provided to the AP by Ramsbottom and another officer revealed that neither received a formal TBI diagnosis until arriving at Fort Hood.

The second officer, who was thrown from his chair by the blast, said he waited weeks after that diagnosis to receive care, having to locate specialists on his own, including a neuro-ophthalmologist for blurred vision, rather than counting on the military medical system.

Maj. Billy Key recounted that he did not receive specialized care until mid-April, when he was assigned to a soldier recovery unit in the U.S. to be treated for head trauma, hearing loss, and lung damage from smoke inhalation.

“It took too long,” he said.

Dr. James Kelly, chief medical scientist at the Invisible Wounds Foundation, noted that delays in diagnosing TBIs remain common, potentially undermining a soldier’s chances for prompt treatment and recovery.

“It’s disappointing but not surprising,” said Kelly, an emeritus professor of neurology at the University of Colorado School of Medicine. “In a war scenario, it goes on a fair bit.”

He emphasized that initial screenings must be conducted by qualified medical staff rather than fellow service members. Kelly added that medical records frequently note only a concussion, which is a mild TBI, leading to the condition being overlooked.

Lincón underwent seven weeks of specialized outpatient therapy at Walter Reed National Military Medical Center in Maryland before returning home to Kansas. The shrapnel in his back remains unremoved because its proximity to his spinal cord poses a risk of paralysis. He continues to experience debilitating dizziness that disrupts his daily life.

Though awarded the Purple Heart, Lincón has returned to active duty as an instructor at Fort Leavenworth. Yet administrative hurdles persisted beyond his medical treatment.

Born in Texas to Mexican parents, Lincón was initially issued only a one-year temporary passport after his original was destroyed in the attack, with officials requesting extra documentation to prove his U.S. citizenship. Following inquiries from the AP to the State Department, the 1995 West Point graduate received a phone call explaining the request was an error and that he would receive a 10-year passport.

“I’m American enough to have fought in three different wars,” Lincón said.

He also fears his medical records remain incomplete. His claim for Traumatic Injury benefits under Servicemembers’ Group Life Insurance was denied for failing to meet hearing loss thresholds, while failing to address his other injuries. The Army’s Human Resources Command did not respond to an email seeking clarification.

“I’m fortunate to survive and that’s how I look at it,” Lincón said. “That’s the only way to look at it at this point.”